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- Title
Stratification of type 1 diabetes risk on the basis of islet autoantibody characteristics.
- Authors
Achenbach, Peter; Warncke, Katharina; Reiter, Jürgen; Naserke, Heike E; Williams, Alistair J K; Bingley, Polly J; Bonifacio, Ezio; Ziegler, Anette-G
- Abstract
Family history of type 1 diabetes and autoantibodies to the islet antigens insulin (IAA), glutamate decarboxylase (GADA), and the protein tyrosine phosphatase-like protein IA-2 (IA-2A) are strong predictors of type 1 diabetes, but the rate of progression to diabetes in multiple islet autoantibody-positive relatives varies widely. We asked whether detailed characterization of islet autoantibodies that included determination of titer, epitope specificity, and IgG subclass would improve diabetes prediction in a large cohort of autoantibody-positive relatives. The study shows a strong association between risk and high titer, broad antibody responses to IA-2 and insulin. The highest risks were associated with high-titer IA-2A and IAA, IgG2, IgG3, and/or IgG4 subclass of IA-2A and IAA, and antibodies to the IA-2-related molecule IA-2beta. Using models based on these antibody characteristics, autoantibody-positive relatives can be classified into groups with risks of diabetes ranging from 7 to 89% within 5 years.
- Publication
Diabetes, 2004, Vol 53, Issue 2, p384
- ISSN
0012-1797
- Publication type
Journal Article
- DOI
10.2337/diabetes.53.2.384